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A Mind That Found Itself: An Autobiography

Creator: Clifford Whittingham Beers (author)
Date: 1910
Publisher: Longmans, Green, and Co., New York
Source: Available at selected libraries

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One might attempt to justify the retention of an attendant of known brutality by saying cavalierly that one vicious attendant is as good as another. This is quite true, but it does not excuse the employment of any vicious attendants. Nor can a valid excuse for so doing be devised. Acceptable if not model attendants can be found if determined efforts are made. Weakly taking for granted that the riff-raff which drifts from one hospital to another must be accepted, the doctors seldom think of actively searching for good material. Yet, in my opinion, this is one of their prime duties. No other detail of management is more important. The difficulty is not insurmountable. There are not a few superintendents who have little trouble in securing an adequate number of fairly competent attendants, but these are usually the heads of institutions conducted on Non-Restraint principles. This fact is not surprising. The better element among those who seek employment as attendants, naturally look for it where the patients are treated with the most consideration; for there the lot of the attendants is not only bearable, but, oftentimes, a happy one.


Brutal attendants are arrant cowards. They would fear to lose their positions more than do most classes of workers, if they were made to realize that the slightest infraction of the rules will insure immediate dismissal. The trouble today is that superintendents, generally, do not enforce rules to the point of dismissal. Thus do those in authority lose a sure opportunity to frighten brutal men into at least a semblance of merciful behavior. Why employ brutal men at all? the reader may wonder. As well ask: why employ dishonest men as clerks and officers in banks. Evil forces must ever be reckoned with; therefore it is incumbent on those in authority to adopt a proper system of espionage, the enforcement of which will reduce evils to a minimum. There is scarcely a department of the Federal Government where just such a system is not now in operation. In business too -- especially its more highly developed branches -- "supervision" is a watchword. Surely, if the sane find it necessary to watch those whose work is carried on under the eyes of the sane, and in the sane world, is it not more necessary to watch those thousands whose work is done behind the locked doors of asylums? The first step in the enforcement of such a system would be a thorough understanding between the superintendent and attendants at the time the latter enter upon their duties. Instead of turning a new attendant over to the old attendants for training, as is so often done, those in authority should themselves assume the task of instruction. To be sure, a majority of our superintendents to-day give words of advice to the newly-hired, but seldom do these preliminary admonitions carry weight. Those in authority should impress upon the mind of the novice the fact that his is a responsible position, and that he must discharge his duties humanely, or submit to summary dismissal; and especially should male attendants be so instructed, for few men are willing to take the course of training which some of our hospitals now offer. Furthermore, attendants -- new and old -- should be frankly informed that, from time to time, under the established system of espionage, personal representatives of the management (spies, if you like) will find their way into the several wards. These detectives may pose either as attendants or as patients and report to the superintendent. A consciousness of the presence of sane eyes will prove salutary.


Who then will watch the superintendent who watches his subordinates? A fair question. Let the public watch and assist him through the instrumentality of a society, organized, of course, for the friendly purpose of co-operation and not with any avowed hostility toward hospital managements. No efficient superintendent ever resents a close or even continued inspection of his institution. And no competent assistant physician or capable attendant would resent an espionage which is designed for the protection of the helpless. Such continued supervision, by eliminating the inefficient, would work to the advantage of the efficient men holding these positions, and would in a comparatively short time raise the standard of treatment to a humane level.


If, also, attendants were made to realize that a dishonorable discharge from one institution would forever bar them from all others, they would soon learn their lesson. A man about to be entrusted with the valuables of others is seldom employed by a commercial institution without a satisfactory certificate of character. Can we tolerate less care in the employing of men and women to whom such a valuable as a human soul is to be entrusted? Yet in a majority of our institutions to-day little care is exercised in the selection of help. Indeed, hospitals for the insane seldom have a full complement of attendants, and a random applicant stands an excellent chance of employment. Hundreds of these "unknowns" are now lording it over insane patients.

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